{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:35:30Z","timestamp":1791531330806,"version":"4.3.4"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":469,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T00:00:00Z","timestamp":1719964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Right ventricular (RV) failure is one of the leading causes of death in patients with pulmonary hypertension (PH). Conventional echocardiographic parameters are not included in risk stratification and follow-up for prognostic assessment due to PH's diverse nature and the RV's complex geometry. RV outflow tract velocity time integral (RVOT VTI) is a simple, non-invasive estimate of pulmonary flow and an echocardiographic surrogate of RV stroke volume. In this study, we aimed to define the prognostic value of RVOT VTI in PH patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixty-three subjects with idiopathic PAH (IPAH) (n = 23), connective tissue disease-associated PAH (CTD-associated PAH) (n = 19) and chronic thromboembolic pulmonary hypertension (CTEPH) (n = 21) were retrospectively included. A comprehensive two-dimensional echocardiographic evaluation, including RVOT-VTI measurement, was performed during the follow-up and the New York Heart Association functional class (NYHA FC), 6 min walk distance (6MWD) and brain natriuretic peptide (BNP) levels were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median age of the whole cohort was 63 years (52\u201368), and 47 (74.6%) of the patients were women. The median follow-up period was 20 months (11\u201333), and 20 (31.7%) patients died in this period. BNP values were higher [317 (210\u2013641) vs 161 (47\u2013466), P = 0.02], and 6MWD values were lower [197.5 \u00b1 89.5 vs 339 \u00b1 146.3, P &amp;lt; 0.0001] in the non-survivor group, and the non-survivor group had a worse NYHA-FC (P = 0.02). Among echocardiographic data, tricuspid annular plane systolic excursion (TAPSE) (15.4 \u00b1 4.8 vs 18.6 \u00b1 4.2, P = 0.01) and RVOT VTI (11.9 \u00b1 4.1 vs 17.2 \u00b1 4.3, P &amp;lt; 0.0001) values were lower whereas right atrial area (RAA) (26.9 \u00b1 10.1 vs 22.2 \u00b1 7.1, P = 0.04) values were higher in the non-survivor group. The area under curve of the RVOT VTI for predicting mortality was 0.82 [95% confidence interval (CI) 0.715\u20130.940, P &amp;lt; 0.0001], and the best cut-off value was 14.7 cm with a sensitivity of 80% and specificity of 77%. Survival was significantly lower in subjects with RVOT VTI \u2264 14.7 cm (log-rank P &amp;lt; 0.0001). Survival rates for patients with RVOT VTI \u2264 14.7 cm were 70% at 1 year, 50% at 2 years, %29 at 3 years and 21% at 5 years. The univariate determinants of all-cause mortality were BNP [hazard ratio (HR) 1.001 (1.001\u20131.002), P = 0.001], 6MWD [HR 0.994 (0.990\u20130.999), P = 0.012] and NYHA-FC III\u2013IV [HR 3.335 (1.103\u201310.083), P = 0.03], TAPSE [HR 0.838 (0.775\u20130.929), P = 0.001], RAA [HR 1.072 (1.013\u20131.135), P = 0.016] and RVOT VTI [HR 0.819 (0.740\u20130.906), P &amp;lt; 0.0001]. RVOT VTI was found to be the only independent determinant of mortality [HR 0.857 (0.766\u20130.960), P = 0.008].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The decreased RVOT VTI predicts mortality in patients with PH and each 1 mm decrease in RVOT VTI increases the risk of mortality by 14.3%. This parameter might serve as an additional parameter in the follow-up of these patients especially when 6MWD and NYHA-FC could not be determined.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14934","type":"journal-article","created":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T01:12:01Z","timestamp":1720055521000},"page":"3332-3340","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Prognostic Value of Right Ventricular Outflow Tract Velocity Time Integral in Patients with Pulmonary Hypertension"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1958-6158","authenticated-orcid":false,"given":"Ayse","family":"Colak","sequence":"first","affiliation":[{"name":"Department of Cardiology, Dokuz Eylul University Faculty of Medicine , Izmir 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